title: Testosterone use in the male infertility population: prescribing patterns and effects on semen and hormonal parameters.
abstract: OBJECTIVE
  To analyze how frequently and why men presenting with infertility take testosterone (T) and if negative effects of T on semen parameters are reversed following cessation.
  
  
  METHODS
  Analysis of a prospectively collected database.
  
  
  METHODS
  Male Infertility clinic.
  
  
  METHODS
  Men presenting for fertility evaluation from 2008 to 2012.
  
  
  METHODS
  None.
  
  
  METHODS
  The frequency and reason for T use in the infertile male population, and semen and hormonal parameters while on T and following discontinuation.
  
  
  RESULTS
  A total of 59/4,400 men (1.3%) reported taking T. T was prescribed by a variety of physicians, including endocrinologists (24%), general practitioners (17%), urologists (15%), gynecologists (5%), and reproductive endocrinologists (3%). Only one of the men admitted that he had obtained T from an illicit source. More than 82% of men were prescribed T for the treatment of hypogonadism, but surprisingly, 12% (7/59) were prescribed T to treat their infertility. While on T, 88.4% of men were azoospermic, but by 6 months after T cessation, 65% of the men without other known causes for azoospermia recovered spermatogenesis.
  
  
  CONCLUSIONS
  In Canada, T was not commonly used by men presenting for fertility investigation (1.3%). Close to 2/3 of infertile men using T recovered spermatogenesis within 6 months of T discontinuation.
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Samplaski
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Yasir
authors.initials: Y
authors.lastname: Loai
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Wong
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kirk C
authors.initials: KC
authors.lastname: Lo
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ethan D
authors.initials: ED
authors.lastname: Grober
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Lunenfeld-Tannenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada. Electronic address: kjarvi@mtsinai.on.ca.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Jarvi
mesh_terms: D000328:Adult; D011307:Drug Prescriptions; D006801:Humans; D007248:Infertility, Male / Q000097:blood* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D012661:Semen / Q000187:drug effects / Q000378:metabolism*; D055101:Semen Analysis / Q000379:methods; D013091:Spermatogenesis / Q000187:drug effects / Q000502:physiology; D013739:Testosterone / Q000097:blood* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013739:Testosterone
keywords: Testosterone; hormones; male infertility; semen; testosterone replacement therapy